active and healthy ageing: the role of physical activity ... · active and healthy ageing: the role...
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Active and healthy ageing: the role of physicalactivity and sedentary behaviour
Prof Dr jannique van Uffelen
KU Leuven – University of Leuven
Department of Movement Sciences
Physical Activity, Sports and Health Research Group
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Sallis JF et al. Behavioral epidemiology: a systematic framework to classify phases of research on health promotion and disease prevention.
Ann Behav Med. 2000;22(4):294-8.
Setting the scene: behavioural epidemiology
1. Establish links
between behaviour
and health
2. Develop Methods
to measure
behaviour
3. Identify factors
that influence
behaviour
4. Evaluate
interventions
5. Translate into
practice
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There are more than 30 supercentenariansin the world
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http://www.grg.org/SC/WorldSCRankingsList.html
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The oldest – still living - person in the worldwas born in the 19th century
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https://en.wikipedia.org/wiki/List_of_the_oldest_living_people
https://en.wikipedia.org/wiki/List_of_the_verified_oldest_people
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Healthy ageing
“ The process of developing and maintaining the
functional ability that enables wellbeing in
older age ”
Intrinsic capacity
mental and physical capacities that a person can draw on
Environments
Physical and social environment
WHO. World Report on Ageing and Health. 2015.
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WHO. World Report on Ageing and Health.2015.
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WHO. Active ageing: a policy framework. 2002
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0
5
10
15
20
25
F - Europe M - Europe F - Belgium M - Belgium
Healthy life yrs at age 65 Life expectancy at age 65
https://ec.europa.eu/eurostat/
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Being sedentary is the same as not beingphysically active
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Definitions
• Physical activity → Bodily movement, produced by the contraction of skeletal muscles, that substantially increases energy expenditure
• Exercise→ Planned structured, repetitive and purposeful, resulting in improvement/maintenance of one or more components of physical fitness
• Sedentary behaviour→ Any waking activity characterized by an energy expenditure ≤ 1.5 metabolic equivalents and a sitting or reclining posture
Caspersen CJ et al. Physical activity, exercise, and physical fitness: definitions and distinctions for health-related research.
Public Health Rep. 1985;100(2):126-31.
http://www.sedentarybehaviour.org/
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Every day activities
Serious exercise!
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Lack of PA is in the top five leading mortality risks in the world
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WHO. Global health risks - Mortality and burden of disease attributable to selected major risks. 2009.
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Disease prevention / risk reduction
↓ all cause + CVD mortality
↓ CVD (incl CAD, stroke)
↓ diabetes
↓ cancer
↓ dementia
↓ risk of falls + related injuries
↓ hypertension
↓ adverse blood lipid profile
↓ weight (re)gain
Psychological
↑ QoL
↑ sleep
↓ anxiety
↓ depression
Functional status
↑ bone health
↑ physical function
↑ cognition
Regular
PA
Social
↑ confidence, mastery, self esteem
↑ social interaction
↑ community engagement
↓ isolation
↓ depressionBauman A et al. Updating the Evidence for Physical Activity: Summative Reviews of the Epidemiological
Evidence, Prevalence, and Interventions to Promote "Active Aging". Gerontologist. 2016 Apr;56 :S268-80
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition.
Washington, DC: U.S. Department of Health and Human Services; 2018..
Bangsbo et al. The Copenhagen consensus conference. Physical activity and ageing. Br J Sports Med 2018
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Increasing levels of
PA is one of the most
important steps older
adults can take to
improve and maintain
their physical, social
and mental health,
and quality of life.
https://movement-pills.nowwemove.com/
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U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans, 2nd edition.
Washington, DC: U.S. Department of Health and Human Services; 2018.
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Aerobic activity
BalanceMuscle
strengthening
U.S. Department of Health and Human Services. Physical Activity Guidelines for Americans,
2nd edition. Washington, DC: U.S. Department of Health and Human Services; 2018.
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GUIDELINES BELGIUM / adults
www.gezondleven.be/themas/beweging-sedentair-gedrag/bewegingsdriehoek
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52,656
72,8
19,216,9
11,7
28,2 27,1
15,5
0
10
20
30
40
50
60
70
80
55-64 yrs 65-74 yrs 75+ yrs
PE
RC
EN
TA
GE
Health Enhancing PA
0
1-149
150+
Majority of older adults do no PA
https://ec.europa.eu/eurostat
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Many factors influence behaviour - SEM
Bauman AE, Reis RS, Sallis JF, Wells JC, Loos RJ, Martin BW. Correlates of physical activity: Why are some people physically active and others not?
Lancet. 2012;380:258-271.
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Starting PA at older age does not result in health benefits
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• n= 3,454
• Followed for 8 yrs (2002/2003 – 2010/2011)
• 63.7 ± 8.9 years at baseline
• PA = self reported, based on frequency vig, mod, light. • Inactive = no mod/vig on weekly basis• Moderate = at least 1/wk mod• Vigorous = at least 1/wk vig
• Which group had the best health 8 years later?
Hamer M, et al. Taking up physical activity in later life and healthy ageing: the English longitudinal study of ageing. Br J Sports Med 2014;48:239–243
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* Adjusted for age, sex, and components of healthy ageing.
Hamer M, et al. Br J Sports Med 2014;48:239–243
1
0,9
0,6
1
0,8
0,7
1
0,7
0,5
1
0,6
0,4
0
0,2
0,4
0,6
0,8
1
1,2
Inactive Moderate activity Vigorous activity
Cognitive impairment
Chronic disease
Depressive symptoms
Physical functionOdds r
atio*
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1
2,4
3,4
7,7
0
1
2
3
4
5
6
7
8
9
Remainedinactive
Became inactive Became active Remained active
Od
ds r
atio
*
* Adjusted for age, sex, marital status, wealth, smoking, alcohol intake.
Hamer M, et al. Br J Sports Med 2014;48:239–243
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1
2,4
3,4
7,7
0
1
2
3
4
5
6
7
8
9
Remainedinactive
Became inactive Became active Remained active
4.4% 10.2% 12.4% 24.3%
Od
ds r
atio
*
* Adjusted for age, sex, marital status, wealth, smoking, alcohol intake.
Hamer M, et al. Br J Sports Med 2014;48:239–243
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Older adults have to meet the PA guidelines for health benefits
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• n= 7,646 women, born 1921-1926
• Surveys 2002, 2005, 2008
• 76-81 years at baseline
• PA = self reporte minutes of walking, moderate and vigorous PA in last week
• MET.min/week
• 7 categories
• Dose response association of PA and walking with QoL?
Heesch KC, van Uffelen et al. Dose-response relationships between physical activity, walking and health-related quality of life in mid-age and older
women. Journal of Epidemiology & Community Health. 201:66;670-677.
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SF
-36
Ph
ysic
al
co
mp
on
en
tscale
(β
)
Concurrent
Prospective
●: Total PA○: Walking
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SF
-36 P
hysic
al
fun
cti
on
ing
(β
)
Concurrent
Prospective
●: Total PA○: Walking
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SF
-36 M
en
tal co
mp
on
en
t scale
(β
)
Concurrent
Prospective
●: Total PA○: Walking
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SF
-36 V
itali
ty (β
) Concurrent
Prospective
●: Total PA○: Walking
In women in their 80s:
• Strong concurrent relationships→ physical and mental HRQoL
• Moderate-strong prospective relationships → physical HRQoL
• Most HRQoL gain with participation in up to sufficient levels
• Similar benefits for walking as for total leisure time PA
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Health is the most important motivator for PA as people age
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• People in their 60s • Health related factors more important than social factors• Gender differences:
• Shift towards social factors as people age
• Habit! Enjoyment!
What motivates older people to do PA?
Health Health/looks Social
improving appearance, losing weight spending time with others, meeting
friends
Van Uffelen et al. Gender differences in physical activity motivators and context preferences: a population-based study in people in their sixties.
BMC Public Health. 2017 Jul 4;17(1):624. doi: 10.1186/s12889-017-4540-0
Zubala A et al. Promotion of physical activity interventions for community dwelling older adults: A systematic review of reviews. PLoS One. 2017:
10;12(7):e0180902.
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Take home messages
• PA has health benefits up to high age, even at levels below PA guidelines
• Benefits can be obtained from a simple activity like walking
• There is a need for multilevel interventions, targeting personal, interpersonal, environmental and policy factors, to encourage people to remain or become active as they age
• Doing something is better than doing
nothing
• You are never too old to start
• Have fun!
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Thank you
KU Leuven
Department of Movement Sciences
Physical Activity, Sports and Health
Research Group